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If you feel that you have the experience and qualifications to be listed on this website, then print this form and send it, along with a cheque for £50 (for 12 months) made out to "Rod Dunn" to: 58 Wycliffe Grove, Werrington, Peterborough, PE4 5DE. Print clearly in black ink.
CLINIC LOCATION __________________________________ THERAPIES OFFERED ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ EXPERIENCE ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ QUALIFICATIONS ______________________________________________________________________________ CONTACT DETAILS Home Telephone _______________________________________ Mobile _______________________________________________ Fax __________________________________________________ Email ________________________________________________ Website _______________________________________________ Address ______________________________________________________________________________ ______________________________________________________________________________ |